CHICKS BEACH RETREAT RESERVATION FORM

TENANT NAME(S):_________________________________________________

__________________________________________________________________

EMAIL:___________________________________

ADDRESS 1:_____________________________________________________

ADDRESS2:______________________________________________________

CITY:___________________________________________________________

STATE:__________________________________________________________

ZIP CODE:__________________________________

HOME PHONE:________-_______-_____________

ALT. PHONE:__________-_______-_____________

BEST TIME TO CALL:________________________

DESIRED CHECK IN DATE:__________________________________________

DESIRED CHECK OUT DATE:________________________________________

Names of Adults Staying:

________________________ _______________________ ______________________

________________________ _______________________ ______________________

No. and ages of Children: _______________________________

No and Type of Pets:_______________________________________________________

Additional Comments/Requests:_____________________________________________

___________________________________________________________________ ____

$500 Security Deposit to be made payable to Lori Panther and mailed with this form to 2104 Cricket Court, Virginia Beach, VA=20 23454.

RESERVATIONS/PAYMENTS - Please confirm your reservation by signing the agreement and mailing back this form with your payment. The entire payment for rent will be due at least 40 days prior to your check in date.

SECURITY DEPOSIT - Tenant is responsible for any and all damages beyond normal wear and tear and for excessive needed cleaning. It is the tenant's responsibility to report any damages or maintenance needed to the property after arrival. If charges are necessary, an itemized list will be sent with the balance of the security deposit or a request for payment if deposit is insufficient within 40 days of departure.

REFUNDS - Tenant shall not be entitled to any refund due to mechanical failure, unforeseeable weather, mandatory evacuation, illness, or disruption of utility service after occupancy.

CANCELLATIONS - In order to cancel a confirmed reservation and receive part of the deposit back, at least 14 days notice must be given and the property must be re-rented to a new tenant. All cancellations of confirmed reservations will be subject to a $150 administration fee. Cancellations must be called in AND followed up in writing.

CHECK IN : No Earlier Than 4:00pm EST

CHECK OUT: No Later Than 10:00 am EST

I understand that this constitutes a binding Agreement between Tenant and Lori Panther, Owner of Chicks Beach Retreat. Kathy Ziskind is the property manager. (757) 403-0260

Lease Agreement must be completed and mailed with rental payment at least 40 days prior to check in date.

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Tenant Date

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Tenant Date